Sponsors (21)
The bill codifies Hyde-like limits on federal Medicaid funding for elective abortion and preserves narrow exceptions (rape, incest, life, certain pregnancy complications) while giving states clear authority, but it will reduce abortion access and increase costs and administrative burdens for low-income Medicaid enrollees and the systems that serve them.
Federal Medicaid funding for elective abortion is explicitly limited (including via waivers and demonstration projects), clarifying that federal dollars will not be used to expand elective abortion coverage.
States retain clear authority to set Medicaid coverage limits for abortion without concern that CMS waivers or demonstrations will impose federal abortion coverage requirements.
Narrow exceptions are preserved: Medicaid/CHIP coverage (under demonstrations) can cover abortions in cases of rape or incest, when the pregnant person's life is at risk (with physician certification), and treatment for miscarriage or ectopic pregnancy.
Medicaid beneficiaries—especially low-income pregnant people—will face reduced access to abortion coverage under Medicaid nationwide.
Low-income women and families will likely incur higher out-of-pocket costs, need to travel out-of-state, or delay care to obtain abortion services that Medicaid will not fund.
Restrictions are likely to exacerbate health inequities for racial and ethnic minorities, who are disproportionately represented among Medicaid enrollees.
Based on analysis of 3 sections of legislative text.
Prevents HHS from approving Section 1115 Medicaid/CHIP waivers that would use federal funds or coverage for elective abortion or abortion-related expenses, with narrow exceptions.
Introduced January 24, 2025 by Josh Brecheen · Last progress January 24, 2025
Prohibits the HHS Secretary from approving any Section 1115 Medicaid demonstration request or extension that would provide federal Medicaid or CHIP funding or coverage for elective abortion or abortion-related expenses (including travel or lodging), while allowing exceptions for rape, incest, life‑saving care as certified by a physician, and treatment for miscarriage or ectopic pregnancy. It also states findings that the Hyde Amendment bars use of federal Medicaid funds for abortions and that Section 1115 waivers cannot be used to override that principle. The restriction takes effect on enactment.